As required by the Deficit Reduction Act of 2005 (DRA), the HAC-POA Indicator Reporting provision requires a quality adjustment in Medicare Severity-Diagnosis Related Group (MS-DRG) payments for certain HACs. IPPS hospitals must submit POA information on principal and all secondary diagnoses for inpatient discharges on or after October 1, 2007. The HAC-POA payment provision under the DRA is distinct from the HAC Reduction Program mandated by Section 3008 of the 2010 Patient Protection and Affordable Care Act, which authorizes the Centers for Medicare & Medicaid Services (CMS
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services, previously known as the Health Care Financing Administration, is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state government…
Full Answer
Do hospitals have to report the POA indicator in Maryland?
Note: Maryland Waiver Hospitals must report the POA indicator on all claims. Include the POA indicator on all claims that involve Medicare inpatient admissions to general IPPS acute care hospitals or other facilities, and you are subject to a law or regulation that mandates the collection of POA indicator information.
Where can I find the list of hospitals with Poa?
You can download the list from the Center for Medicare & Medicaid Services (CMS) website, at Hospital Acquired Conditions (Present on Admission) - Coding The following hospitals are exempt: Note: Maryland Waiver Hospitals must report the POA indicator on all claims.
When should I include the POA indicator on my claims?
Include the POA indicator on all claims that involve Medicare inpatient admissions to general IPPS acute care hospitals or other facilities, and you are subject to a law or regulation that mandates the collection of POA indicator information. POA is defined as being present at the time the order for inpatient admission occurs. Conditions
Where can I find the POA exempt list?
Please review the POA exempt list to ensure you are submitting your claims correctly. You can download the list from the Center for Medicare & Medicaid Services (CMS) website, at Hospital Acquired Conditions (Present on Admission) - Coding The following hospitals are exempt:
What is POA indicator reporting?
POA indicator reporting is mandatory for all claims involving inpatient admissions to general acute care hospitals or other facilities. POA is defined as present at the time the order for inpatient admission occurs.
What is POA in medical?
Conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA. A POA Indicator must be assigned to principal and secondary diagnoses (as defined in Section II of the Official Guidelines for Coding and Reporting) and the external cause of injury codes.
Does CMS require POA?
CMS does not require a POA Indicator for an external cause of injury code unless it is being reported as an "other diagnosis.". Issues related to inconsistent, missing, conflicting, or unclear documentation must be resolved by the provider.
How to become a power of attorney for Medicare?
If you want to be the representative payee for someone on Social Security, go to the local office. At the Social Security office, submit a letter from the recipient’s doctor that states the need for a representative payee. Also, you’ll need to have proof of identity.
What is a durable power of attorney?
Durable Power of Attorney gives financial legal authority to an agent when the principal is either capable or incapable. Conventional Power of Attorney is granted to the agent when the principal is unfit.
When is a springing power of attorney granted?
Conventional Power of Attorney is granted to the agent when the principal is unfit. Springing Power of Attorney only occurs when the document is signed, and it stays in effect throughout the principal’s life. An attorney can notarize any documents in your state. Each state has different rules.
Is a power of attorney enough for Medicare?
Is Having a Standard Power of Attorney Enough for Medicare? Having a standard power of attorney isn’t enough when it comes to Medicare or Social Security. Standard power of attorney allows you to handle most of the finances; but, it doesn’t allow you to make health care choices.
Can a power of attorney negotiate Social Security?
A person with power of attorney has the authority to manage limited benefits. A power of attorney can’t negotiate federal payments such as Social Security checks. So, if you need to handle affairs for someone unable to manage their benefits, you’ll need to apply for Representative Payee.
Does Medicare recognize power of attorney?
Yes, Medicare recognizes power of attorney as legal authorization when someone else is acting on behalf of the beneficiary. Does a representative payee have limits? Unless you’re the guardian, you can’t sign a legal document for the beneficiary.
What is POA indicator?
Include the POA indicator on all claims that involve Medicare inpatient admissions to general IPPS acute care hospitals or other facilities, and you are subject to a law or regulation that mandates the collection of POA indicator information.
What is POA in medical terms?
Present on Admission (POA) is defined as being present at the time the order for inpatient admission occurs. Conditions that develop during an outpatient encounter, including emergency department and/or observation services, or outpatient surgery, are considered POA.
Can you use medical records to determine POA?
You may use medical record documentation from any provider involved in the care and treatment of the patient to determine whether a condition is POA. The importance of consistent, complete documentation in the medical record cannot be overemphasized.
Do you need a POA indicator for external cause of injury?
CMS does not require a POA indicator for the external cause of injury code unless you are reporting it as an “other diagnosis.
What is POA in claims?
The POA data element on your electronic claims must contain the letters “POA”, followed by a single POA indicator for every diagnosis that you report. The POA indicator for the principal diagnosis should be the first indicator after “POA,” and (when applicable) the POA indicators for secondary diagnoses would follow.
What is POA indicator?
POA indicators are assigned to principal and secondary diagnoses and the external cause of injury codes.
When did hospitals start reporting secondary diagnoses?
Section 5001 (c) of the Deficit Reduction Act of 2005 requires hospitals to begin reporting the secondary diagnoses that are present on admission (POA) of patients effective for discharges on or after October 1, 2007. By October 1, 2007, the Centers for Medicare & Medicaid Services ...
When did CMS collect information on hospital claims?
Between October 1, 2007, and December 31, 2007, CMS will collect the information on the hospital claim, but does not intend to provide any remittance or other information to hospitals if the information is not submitted correctly for each diagnosis on the claim.